Note for other medical students

I've decided to write a final post for any medical students thinking about going to Helena Goldie as I've noticed I'm getting a bit of traffic from google searches.

I can highly recommend the elective as I really had a wonderful time. It does depend what you're looking for though. 

Helena Goldie Hospital - looking towards the office and operating theatre

The Solomons are very expensive to get to from the UK in terms of flights and whilst buying fresh food at the markets is cheap, it wasn't the cheapest elective I could have had. 

In terms of accommodation I first stayed at Robina House at the hospital which is a really lovely little house, ideal for medical students. All payments go to the hospital as well so staying there is supporting the hospital. However it does mean that if you want to go into town and to go diving/shopping/to the hotel for a drink, it's a 30 min walk (each way) in the heat. With the sun going down at around 6pm every night it also means you have to leave before dark. If you're there with other medical students though you can do the walk in the dark as long as you have a couple of good torches (head-torches are ideal). Just watch out for crabs and frogs on the path.

Qua Roviana Guesthouse

For these reasons, I chose to stay at Qua Roviana, a guesthouse in town for the remainder of my stay. It was a bit cheaper, and in town so meant I could be a bit more sociable in the evenings. I don't think they have a website but if you want to contact them the easiest way would be via the Jen or Graeme at the dive shop. However, if you choose not to stay at Robina House, Helena Goldie hospital will charge you an elective fee so it's worth finding out the costs of everything before you decide.

Here's a link to the hospital website:http://hghospital.jimdo.com/

Medical Stuff:

If you want to go to a 3rd World Country where you get to manage your own patients and run clinics and operate on patients then Helena Goldie probably isn't right for that. There are enough doctors at the hospital to go around really, and so you will not be able to have free reign. However, you will get to assist in operations, and will be asked for your opinion on management of patients during ward rounds. You will also be able to 'essentially' run your own outpatient clinics with one of the other doctors around for help and opinions (to make any final decisions). So you can get a lot out of it if you make the effort. It's a great place to improve your basic examination and diagnostic skills as they don't have even fairly basic blood tests (U&Es, LFTs). 

Drs Graham and Jenny have a blog which they update periodically (as their internet access is very limited) which might help you understand a bit more. I'm sure they'd also be happy to be contacted.

http://grahamandjenny.co.uk/

The best part of my trip to Munda was the diving! The water is generally warm (30degrees even when 30m down), and the visibility is (usually) incredible. If you've never scuba-dived before I can highly recommend learning with DiveMunda. If you are already a diver then you'll absolutely love it and there's plenty to see. If you prefer snorkelling then you really wont be disappointed and it is cheaper. Tetepare Island is a MUST for a visit - really a wonderful example of responsible tourism. And if you're interested in the WWII history of the Island, then get Barney to take you on a tour (and watch the Pacific TV series).

Dive Munda Website: http://www.mundadive.com/home.htm

Sunset from Agnes Lodge

Betel/Beetle/Bitel Nut

There is a very popular drug in the Solomon Islands that grows naturally here. It’s a small nut called Betel nut (pronounced beetle). It seems to act as a bit of a relaxant, and was traditionally used before big community meetings and debates to calm everyone down so that discussions didn’t get too heated. But, like every drug, it has it’s addicts. 

I didn’t get around to having a try of any, but thought I’d relate the process and what it’s like from what Mia told me. 

Powder, Betel nut, and sticks

You buy the nut along with the required lime powder  stick from any local market for around $2 (around 20p) and then you get a bush lime as well. You take the green skin off the betel nut and inside, is the little nut. It apparently looks a bit like a large browny macadamia nut – about the size of a walnut, but round. You then chew it until it gets soft  - I’m told it doesn’t taste all that great (apparently it also makes you salivate quite a lot). Next, you get a mustard stick, and dip it in the lime powder and bite that (with the betel nut still in your mouth). The result is a reaction to the lime powder which gives you the desired buzz and also turns the liquid a BRIGHT red. You then spit out the liquid when you’re done – and if you happen to be walking down the street you spit it right there – this is why I was a bit concerned that there were blood spatters EVERYWHERE when I arrived in Honiara. 

leftovers (normally spat onto street)

Different people have different reactions to the process. Some say they get a bit relaxed and calm. Most people get hot and a bit sweaty. Others get light headed and nauseous. Also, apparently you can increase the hit by chewing with tobacco as well. 

I’d really like to know what the chemical is that causes its effect as I’m not sure how much of addictions to it are social/emotional or whether is much physical dependence. One definite problem is that it does lead to skin cancers of the mouth – Mia has shown me a picture of one on the inside of someone’s lip – about the size of a tennis ball – not pretty!

Wantok:

The word ‘wantok’ in the Solomons refers to ‘family’. However, like in Africa, family doesn’t mean your parents, siblings or children. It usually refers to anyone who is related to, and sometimes to your whole village or tribe. That’s the meaning of the word, but culturally, the concept of wantok is far more complicated. 

You cannot say no to anyone in your wantok. If they turn up on your doorstop asking for help, you have to help them. If they see you on the street with your new pair of sunglasses and ask you if they can have them, you hand them over. If you own a business, they have a right to share in the profits and at times simply walk off with the produce. I’m sure that this wasn’t the original manifestation of the wantok principles of helping everyone in your area when they needed it, making sure people don’t starve, but in a modern world it can be a bit of a hinderance. It basically means that Solomon Islanders struggle to run their own business without being dishonest to their family. Consequently, most businesses such as supermarkets (particularly in the capital, Honiara) are owned by the Chinese.  It also means that government jobs are staffed by family members and government resources are used by relatives. Those who get good jobs often become a bit reclusive to try and avoid running into family members, but they still turn up on the doorstep at all hours of the day. 

Wantok catching a lift home

On the other hand, there are some times when it is advantageous, and the main one I saw was when people become ill. There is no blood donation service in the country, so blood is donated by family members, and when several units are needed, many family members have to donate in order to get the right number of matched units. When the family can’t say no, then it’s not as hard as you might expect in another country. Similarly, if people come to the hospital from far and wide, instead of discharging them home, you ask if they have wantok in the area that they can stay with and come back as an outpatient. It saves a lot of hospital resources and patients usually prefer it.

I do wonder whether this aspect of their culture may end up changing and eventually being lost in the effort to progress in a capitalist way. I think in many ways it would be a shame as it certainly helps to unite people and prevent starvation and extreme poverty. On the other hand, it's hard to know how the country will survive if changes don't happen. It would be interesting to come back in 30 years and see if anything has changed. 

Last days as a Tie Vaka

(Tie Vaka is the colloquial term for foreigners – roughly translated as ‘newly arrived in a boat’)

Honiara chinese: lobster and duck - yum!

I left Munda yesterday with mixed feelings. I was looking forward to spending Christmas with my family for the first time in over 10 years, and Rich’s first hot Christmas (he still thinks it’s weird!). On the other hand, I was very sad to leave all the lovely people that I’ve met and made friends with in Munda. There are some fascinating people living and working in that town, and I was made to feel a part of the community, albeit a fairly transient part. All in all, it felt very strange to get on that plane after a very quick 6 weeks. 

I very quickly cheered up on landing in Seghe when Mia and her boyfriend Zak boarded the plane to join us on the trip to Honiara. We spent the rest of the flight catching up and gossiping about the travellers we’d met in the last couple of weeks. We shared a cab into town, and after settling in to my hotel, I met up with them again that afternoon for some souvenir shopping. Then we all went out for a fantastic Chinese meal. It’s really great to have their company in the city, and I’ve repaid the favour by letting them use the shower in my hotel room because the place they’re staying has got no running water at the moment (it is free though!). First hot water Mia has had in 10 weeks. 

So, today, after a few hours chilling in the best coffee shop (only coffee shop?) in town I shall be heading off to the airport and heading back to Brisbane. It’s been a wonderful few weeks and I’m sad that it’s over – for anyone thinking of doing an elective here, I recommend it very highly. 

Life as a tie vaka has been pretty cool!

The swimming pool at the hotel (a worthwhile extravagance!)

Final weekend in Munda

Friday evening was a fairly quiet one owing to the fact that I’d had my first coffee in 6 weeks the night before, meaning that I wasn’t able to sleep for hours! So I joined my Munda mates for a few sundowners and a bit of banter over the cricket (sometimes it’s good being surrounded by Australians!), but I faded early so that I could be fresh for my final day’s diving.

Saturday was a spectacularly beautiful day and I tried to really enjoy the scenery knowing it would be the last time I went out on the boat to the reefs and nearby islands. The diving was pretty incredible too. Thanks to the excellent teaching of Jen and Graeme, I really felt like a diver in the water, and my dive buddy Sam, who I did my course with was always calm and I think we both felt at ease. We did 2 dives, and saw quite a bit – several reef sharks and bumphead parrot fish (ugliest fish I’ve ever seen), barracuda and clownfish, not to mention a rather scary attack from a trigger fish. Trigger fish are aggressive little things with nasty sharp teeth that will take a good bite out of you (through wetsuits although we weren’t wearing any) about the size of a £1 (AUS$2) coin. I was a little jumpy, but Graeme managed to kick it away quite effectively with his fins.

Dive Buddy Sam

Sam and I both managed our underwater drills with no problems and even the mask removing one was fine for me. So now we are both properly qualified open water divers which is great as it means I can now dive anywhere. I might be avoiding Sharm el Sheikh for the time being though!

One downside of the day spent diving is that I was left with a bit of a farmer burn (I can’t tan so can’t get a farmer tan). It had pretty much faded by Sunday though so hopefully I don’t look TOO ridiculous. Sunday was spent relaxing and playing cards. Incidentally, if anyone is looking for a good card game, ‘Monopoly Deals’ cards are a much better game than Monopoly the board game and I highly recommend them as a Christmas present for your family. Then I sat watching my final Munda sunset with a group of friends over beers and g&ts, giving Roger and the Aussies stick for the cricket (did I mention it’s great being surrounded by Aussies this week?!).

Ah, I’m going to miss Munda! 

Final Market

Friday was my last ‘market day’ in Munda. There’s a market every day, but the market on Friday is usually quite a bit bigger and people travel from all over to sell their wares, and obviously others to buy.  It usually means that there’s a greater variety of foods available and you can even get pineapples! It’s a great day to stock up on veggies as the quality is usually a bit better.

The atmosphere is always more vibrant and one of the local ‘supermarkets’ hires a guy to make sales pitches on a loudspeaker for all the town to hear. I can hear it from my room so by 4pm I’m usually very keen for the shop to close. After the markets and shops finish, the drinking begins in earnest. The nearby Cava bar is generally buzzing, and although they’re usually relatively well behaved, the work for the policemen tends to increase on Fridays.

Interestingly, the influx of people to the area also leads to an influx of people to the clinic at the hospital, and Dr Jenny and the other doctors are usually run off their feet for the day. It seems that most people can get lifts with their relatives who are coming to sell their wares and so they generally bring their entire family for checkups. 

World AIDS day:

Main stage

Today is World AIDS day and the hospital and local community organise an educational festival to mark it. A bit like the Women’s day last week, but on a bigger scale. They started off with a parade on the back of a couple of trucks from just beyond the hospital, into the main town centre. They had set up a big stage yesterday and had a few dignitaries including 2 doctors (the male ones) from Helena Goldie.  They played some popular music to get things going and once a few people had gathered had a few speeches. Then there were some musicians who played not-so-traditional pipe instruments. The traditional ones are made out of large bamboo pipes of different lengths which they bang the ends of to make a sound a bit like a marimba (African instrument) but a bit more hollow – which makes sense. These ones were made from pvc piping, and they also had a couple of drums and a string with some bottle-tops tied to it which served as a kind of tambourine of sorts. The teenagers playing had great rhythm, and they were just clearly enjoying themselves.

PVC pipe players

Then there were some little kids who danced, and then some more music and speeches. I have to say I didn’t stay for the WHOLE thing because it’s unbelievably hot and humid today and it was all in the sun. I just went past a few times to see if there was anything new.  I’m told there will be some plays and a big singing competition – the runner-up last year had a song that basically consisted of the word ‘condom’ over and over again. Still, whatever gets the message across I suppose!

Later this afternoon, I went to watch the children’s Christmas party for the local school. It was very sweet although they did sing one song about acid rain and how technology is making us less human which I found a bit disturbing coming from 7 year old mouths. The best part was when Father Christmas was brought over in full winter Father Christmas outfit to give out the presents. How he didn’t faint I will never know, but it was good fun to watch – especially as he bears an uncanny resemblance to a particular RAMSI officer (albeit with a little paunch). All the little kids were very scared to shake his hand – so sweet.

A very warm Santa Clause

All in all the atmosphere today has been very festive and everyone was very cheerful – an excellent day to be in Munda!

Pijin/Pidgin/Pidgeon: The basics

I thought that since it’s my last week, I’d relay a few of the things I’ve learned about the language from taking medical histories from people in Munda. I don’t pretend to be fluent, I don’t even pretend to be able to say more than a few words and even those are probably said very badly – however, a couple of people have asked me to tell them some words so I figured I’d give it a go – most of the words I’ve learned are useful when asking medical questions so you might find some difficult to use in conversation.

Firstly, one thing I should say that the language Pijin is spoken across the country, but in the Western Province (where I am) they mostly speak another language, Roviana, which is completely different and actually unrelated to English. So I know some words in Pijin, but also some in Roviana and I’m not always sure which is which. Another thing, spelling here seems to be entirely phonetic, and they actually don’t seem to care how many are spelled and so the same word may be written differently within the same sentence. For that reason, I have no idea how to spell words so will just try and spell so you can ‘hear’ the words.

Kai-kai – food/eating – e.g you kaikai good?

Sigity – pain (Roviana)

Soa (pron. Sohwah) – pain (Pijin) – can also be ‘pen’

Hillily – burning

Mimi – urine

Toilet – bowel stuff

Ekho – lie down

Pikinini – children

Papopua – home – also ‘ples blong mi’ (see below)

Tumas – too/very much – e.g. thank you tumas – (I thought there were a lot of people named Thomas when I first arrived)

Stacka – lots

Save (pron. Sahveh)  – to know

Baskit – bag

Plastik – plastic bag

Lilbet – little bit

Some grammar:

He/she/it = Hem – (quite useful when doing baby checks - no awkward boy/girl queries)

Mi = Me/I – You don’t use the word I here, it’s always Mi/Me

Fala – used with numbers/plurals – e.g. I want 2 mangoes – Mi likem 2 fala mango

Blong – Possessive (ie belonging to) – e.g. Pikinini blong mi – my children

No – negative – e.g. mi no save – I don’t know

Non-verbal:

Raising eyebrows – means yes – the British doctors found it frustrating when taking histories because it took them weeks to realise that the patients WERE answering their questions.

Finally – after this rather pathetic attempt to explain some words, there’s a much better explanation on the hospital website for anyone who’s interested.

Scuba diving....check!

I am now officially a scuba diver - it's something I've always wanted to do and I'm very pleased I have. 
Most people do the 'confined water' dives part of the diving course in a swimming pool but they don't seem to have those here - why bother when you can swim in the sea! So yesterday we went to an island (the picture postcard one with the hammocks - see earlier photos) and learnt the basic skills just off the shore, going deeper as we got a bit more confident. It's a lovely small group, with just one other student and the instructor. I thought I would find it difficult to do things like take the regulator (the thing that you get your air from) out and put it back in, but in fact the thing I HATED was taking my mask off - it's surprisingly difficult to stop yourself breathing through your nose. I managed to do it though and had a really good day.
Today we did proper diving - it was absolutely amazing! We saw a juvenile leopard shark, a couple of reef sharks, some stingrays (eagle) and crayfish, not to mention a huge amount of fish. It was SO much fun and unfortunately it may become an expensive hobby. I am still going to have to get more practice equalising as I spent a lot of time going up and down trying to stop my ears from hurting.
This all means that I can now dive with an instructor, and by next weekend I'll be able to dive on my own (well, with a buddy). 

Payback......

I moved into the main town last week after Tetepare with the other med students, and have stayed once they both left. The hostel/motel place that I’m in is great and quite a bit cheaper and even has satellite tv in the lounge.

However, the other people staying here are all male, and I think most are Malaysian workers. They are very polite and friendly, but all of this week they commandeered the tv and have been watching WWE (wrestling), all day and night. They’ve also found it amusing to play music from about 5am in the next room and unfortunately the walls are paper thin.

So, yesterday I got home from the hospital and politely asked if they knew if the cricket (Ashes) were on the tv. So they changed it for me and I spent all afternoon watching the England batting – a fun afternoon despite the depressing performance towards the end (or Siddle’s impressive performance depending on which side you’re on)

Today I got back to find the tv unattended so sat down and put the cricket on again. People kept walking into the lounge looking at the tv with disappointment. A few have asked me who won or if it’s the highlights from yesterday. I have to say I quite enjoy watching their faces fall when I tell them it’s the same game, but this is day 2 of 5! I don’t think they quite realised how long a game of cricket takes. One canny person got the better of me by boldly sitting IN my chair where my phone and laptop and keys were, changing the channel in the 5 minutes it took me to put my washing on. I didn’t have the guts to protest but just sat behind them until they both got a bit bored or maybe they felt guilty and left me the remote.

Luckily for them I’ll be spending tomorrow finishing my PADI diving course so they will be able to watch wrestling to their hearts’ content.

Murmurs, malaria and missing fingers:

The hospital hasn’t been too busy this week. I’ve had quite a few baby checks to do though, and have thankfully managed to pick up a couple of heart murmurs and one baby with talipes (club foot) which Dr Zotei (the doc with a paeds interest) confirmed so at least I know I’m doing them right. There’s one poor little baby with hydrocephalus (water on the brain) and an encephalocele who has failed to respond to any medication so they’ve been discharged to spend time at home until he gets sicker. It’s very sad, but there’s nothing they can do for him as it’d cost AUS$30,000 to get him to Brisbane for an operation and even then, the operation may not be effective.

The general ward has been much the same as usual although one patient may be going into renal failure but there’s not really any way to know for sure seeing as they can’t do the blood tests. There was one man who came in on Sunday night who had got his hand caught between a rock and a hard place (literally) and ended up losing 2½ fingers. He was working at a logging company and is one of many examples of why Health and Safety precautions might be a good idea here.  Luckily they brought him in within 30mins, so his hands were stitched up quickly and nothing seems to be infected. Another man had a large laceration on the back of his calf last weekend, but because he was out at sea, he took 3 days to get to us and it all looked a bit messy by the time it was stitched. Otherwise, there were a couple of cases of malaria and TB which is fairly normal here.

I spent much of today in outpatients which was fun because you get to pretty much manage your own patients. I referred anything interesting to the doctor, but got to diagnose and treat the minor stuff and even managed to speak a little bit of Pidjin – I’m sure they were laughing at me on the inside but they were very polite and pretended to understand. 

Alex and Mia's leaving do

So Alex is leaving to head back to the UK on Monday, and Mia will be moving on to a week’s placement in Gizo Hospital the same day (leaving me all alone in Munda). So we figured it was a good excuse to enjoy a few drinks with friends over the weekend.

On Friday we decided to give Cava (sp) a try. This is an ‘interesting’ drink made throughout the Pacific, from some kind of root – I think. The root is generally sold as a beige coloured powder, which is then made into a beige soupy looking drink. It tastes absolutely disgusting! It tastes like dirt, or maybe like Chinese herbs – very dusty. EURGH! After the first ladle-full (traditionally it’s served in coconut shells but we only had kitchen stuff) it just made my tongue and mouth numb. The second one made me feel a tiny bit mellow and chilled (but that may have been the sunset). I couldn’t face having a 3^rd one (yuck-bleurgh!) but I’m told you feel progressively more and more relaxed. So much so, that if you overindulge, you can actually feel physically unable to get up the next morning – according to Daniel (Argentinian tourist who Alex and I met randomly during our travels!)

On Saturday, Roger, Chere, Brendan and Daniel came round for a braai (they didn’t call it that but I do) and Alex had managed to procure some bottles of rum – we wanted vodka but alcohol is difficult to come by here unless it’s SolBrew beer. Alex has proven to be an excellent cook and the chicken he cooked was fantastic. After dinner he brought out all his loose change that he’d collected over the 7 weeks and we taught everyone how to play Texas Hold’em. Fortunately, 2 bottles of rum between 7 of us doesn’t lead to hangovers, so we’re all feeling pretty good today.

Hospital bits for the week:

Posing outside the hospital

We seem to have settled into a routine for the hospital, and while it may change next week when I’m the only student around, it seems to work fairly well at the moment.

First thing in the morning is General Ward rounds. Very similar to those in the UK, where we just go from bed to bed, seeing how the patients did overnight and discussing any potential change in management. However, unlike in the UK, we’re actually asked for our opinions – and not in an ‘I’m-asking-for-your-opinion-so-I-can-grill-you-on-your-knowledge’ kind of way. There have been quite a few times when they’ve changed their management because of what we’ve said. Quite daunting at first, but it does keep us on our toes and means we don’t tend to fall asleep whilst they’re talking about things. One thing we do have to keep in mind is what more can actually be done, seeing as they don’t have even the most basic of blood tests (no LFTs, U&Es and only rudimentary FBCs). There isn't a CT scanner in the whole of the Solomon Islands!

After ward round, we head over to the maternity ward, where we do the ward round and baby checks on all the newborns. I had been told they get about 30-50 births per month, but think that’s a bit low – it’s probably closer to 75, so 1-2 babies to check every day. Syphilis is very common here, so they always check for that, and mom and baby often need to have a course of antibiotics. Ironically, the nurses don’t seem to understand the disease very well, so one doctor asked me to get out some of my lecture notes on it and give a tutorial on Monday – (I’d never seen a case until I came out here).

After baby checks we go and see what’s happening in theatre. On Tuesdays and Thursdays they tend to schedule operations so on other days there may be the occasional urgent appendicectomy or something, but it’s mostly just dressings of large wounds that might need to be done under ketamine or local anaesthetic. I say ‘just’ but in fact some of those wounds are incredibly large and nasty. Don’t get diabetes in a humid, tropical country let me tell you! I won’t subject the squeamish amongst you to the photos I have, but I will have a large folder full for those of you interested when I get back. Lucky they haven’t invented cameras to record smells yet.

Lobster Night!

Alex has been here for 7 weeks now, and decided early in his trip to organise a lobster dinner at the lodge/hotel because the lobster here is meant to be amazing. Thankfully for Mia and I, he decided to save it till his last week and the date was set for Thursday, and he recruited a few others – Roger (from the Tetepare office), Chere and Brendan (Australian/Ramsay police members stationed here)

ASIDE: For those of you who’ve known me a long time, you may know that I’m not a big fish/seafood eater. I’m conscious of the fact that this is because the variety of fresh fish/seafood available in (landlocked) Zimbabwe when I was growing up, wasn’t great so I never got into the habit of eating it or even being around it. My brother and I were also very fussy eaters so my mom probably couldn’t be bothered to try and force us.

However, I wanted to try and eat more fish when out here because it’s pretty much as fresh as you can get, and the variety is incredible. I have largely succeeded having eaten a LOT while out here and so I felt like lobster would be a new challenge.

So on ‘lobster night’, we all gathered on the deck restaurant at the lodge and waited for our food to arrive. We were not disappointed! We had a wonderful lime and coconut kind of cerviche (sp) dish to start and then the  lobsters were HUGE. I couldn’t even finish mine, but fortunately the boys were kind enough to offer to help me out. So my first lobster experience was a great one and hopefully I can repeat it – although, I have to say I think I preferred the starter. (such  a pleb!)

Tetepare Turtle Fun:

After a 2 hour snorkel on Sunday morning (very tiring but gorgeous – only 5 sharks this time) we had a quiet afternoon because we were going out to camp on the turtle nesting beaches overnight.

The boat left late afternoon, arriving at the beach in a very eventful way. Because of the big waves, the guides had to skilfully surf the waves in the little motorised boat till we landed on the sand; at which point we had to all jump out and drag the boat up the beach. Because the boat could only take 3 of us at a time, it had to be done 3 times, and we were all soaked and laughing by the end.

By the time we were all out and on ‘dry’ land, it was sunset so we all stood taking lots of pictures until it was time for dinner in our little shack. Dinner was all cooked and laid out from the resort, so no making fires or any of that hassle – roughing it in style – yum! The medics amongst us also spotted the whale vertebrae just dotted around the jungle which nobody else had ever noticed.

Then we all took a walk out to the end of the beach (about a mile down the way) and settled down in the sand for the night, to wait to see if any turtles came to lay some eggs. Whilst we were unlucky with the turtles (as none came overnight), as far as the experience goes, it was well worth the lack of sleep:

The beach sand is volcanic, so is actually black, and it glistened beautifully in the moonlight. The stars were beautiful and it was just so peaceful to lie back and watch them, while listening to the waves on the beach a bit below.

Finally, on the last day, they saved the best activity........Turtle rodeo!! The guides have to measure and tag turtles so luckily for us, they let the guests watch the show. What happens is that the guides stand on the roof of the front of the boat, and look for a turtle in the water (the water is so clear that they can see them). Then they chase it around for a bit i(with the boat) until it gets to a shallower area and close enough for one ranger to literally jump on top of it. Then he kind of hugs it and holds on to the flippers and passes it into the boat. Once they have 2 or 3 like this, they head for a beach to put them down onto so that the measurements and tagging can be done. Such a brilliant experience!

Tetepare adventures (part 1) –

(Pronounced Teh-teh-par-ray)

We set out on our little boat on Friday morning, not really knowing what to expect. We’d been told it was very basic accommodation, and there were millions of insects and flies, but that it was amazing. All of this turned out to be completely true.

Our journey out was fairly eventful spent watching the stunning scenery. We got to see a few flying fish, and then happened to go through a large pod of spinner dolphins who started chasing the boat for a few seconds – magical!

The malaria curing tree

When we arrived on the island, we were greeted by our guides and taken to the leaf huts which were to be our accommodation.  They were basic, but very comfortable and clean, and the hammocks outside were so good to laze around in. Later that day we went for a bush-walk where Tuni (sp) our guide showed us all the bush medicines for curing pretty much everything from malaria, to bone fractures, to high blood pressure. Not so sure about the one that mends bones, but it sounds like some of them might have value. 

We ended our walk at ‘crocodile lake’ where thankfully the largest reptiles we saw were monitor lizards, despite the enthusiastic dog imitations perfomed by the guides. The boat then picked us up and took us back to the dugong zone for us to snorkel. Whilst a couple of people managed to catch sight of the dugongs, they’re really shy creatures and as soon as the rest of us tried to swim closer, they fled. The whole area is a marine conservation area though, so fishing is not allowed, and for that reason, the fish are 2-4 times the size of the other fish in the area.

The next day we set off to have a look at the bat cave. We had originally expected to go to a large cave in the boat, but that one was damaged in an earthquake in January. So we went to a much smaller one, where you had to crouch down all the way to the main cave at which point the idea was you’d scare the bats out and watch them fly around. I am ashamed to say that the thought of hundreds of bats flying at my face in that small space was too much for me and I chickened out only about ⅓ of the way in. Got a good picture of a bat flying at Mia though – one eventually sat on her head for a few seconds. 

weekend away

Well it's been a fairly normal week so far for us. The hospital was a bit subdued on Tuesday because unfortunately 2 patients died on Monday night. They were both acutely ill and we can't think of anything more that could have been done here, but they don't do post-mortems unless there's possible foul play, so we'll never know. 
Otherwise, things just plodded along as normal. Mia went out 'on tour' in the boat with one of the doctors as well as a couple of nurses and the dentist. They visit areas that would otherwise not have any care but because these areas are quite numerous, most only get visited once every 6 months. Apart from one with a district nurse based there, that means that they have to wait for this, or paddle (or get their family members to paddle) the 4-8hrs to the hospital. This explains why many patients present so late in their illnesses. Hopefully I'll be going out on a similar tour with some of the nurses next week if they go. 
I don't think I'll be posting any updates until Monday as a few of us are going to an island called Tetepare about 90mins boat journey from here for the weekend. It's very remote, but is meant to be beautiful, and I'm really hoping that we might see dugongs, or MAYBE turtles nesting!
Hopefully I will have lots to tell, and lots more photos by the time we all get back.

The earth moved, under my feet:

I fell asleep last night having finished another book, and was suddenly woken up by shaking. At first I thought that the burglars that have apparently been around the last few days were under the house. As I woke up a bit more, I realised that was unlikely and I’d probably just felt my first ever earthquake. My next thought was “Does that mean that there’ll be a tsunami now?”

So I immediately peered out at the window behind me to look at the sea, because supposedly you see warning signs of the ocean receding to tell you the big wave is coming so you can run for your life. Then I realised that since it was pitch black outside I wouldn’t be able to see the water receding. So I then stared at the reflection of the lights of distant houses in the water along the coast and tried to see if the water was moving. Unable to see if there were even waves in the water, I gave up on the idea of that as a warning and started to wonder if the police or even the hospital would get a warning if they thought a wave was coming. I hoped that they would ring the big gong outside to warn people.

So then I started to think about what I should grab if the gong was sounded – I settled on my phone, computer and rucksack, but really can’t remember why – surely a few pieces of fruit or a torch would have been a better idea!

After that, I realised that surely a tsunami would need a bigger earthquake to form, and seeing as the one I’d felt had lasted about 5 seconds and had barely shaken the table next to my bed it was unlikely to cause any problems. So then I went back to sleep!

more water sports...

We (Mia and I) actually decided to go into the water today. We joined the divers at their 3 sites today, and while they went down we stuck to the surface snorkelling and marvelling at the sights below. 
The amount and variety of fish we saw was absolutely incredible. I just wish I knew all the names so that I could tell you all. I know for sure we saw clownfish (Nemofish!!), parrotfish, trumpetfish, and angelfish. Beyond that, I'm a bit useless I'm afraid. 
We saw 4 sharks on the first dive/snorkel - all reef sharks fortunately, but by the end I was getting pretty jumpy. Only 2 on the 2nd one. The 3rd one we only snorkelled for about 15 mins because the fish were a bit deep for us to see properly. Still saw one shark in that time though. 
Personally I believe 7 sharks in a day (even if they're small or supposedly harmless) is plenty and in all honesty, the fewer the better! However, there are a lot of mental people here who seem to think that the more and closer the better, and would probably be enjoying it if a big one came up to them with it's jaws wide open. 
Surface intervals - so divers can prevent 'the bends' - were pretty lovely - we were taken to little beaches on the islands for a snack and some water and a bit of a rest. The 2nd one had a hammock which we all enjoyed!

Oh, and don't worry Mom, I was very careful and made sure I had about an inch of sunblock on every exposed bit of skin. I shall sleep very well tonight though!

Water sports

Every outdoor activity worth trying out over here involves water.

Last weekend I went snorkelling, which I loved but unfortunately it tends to involve a LOT of suncream or else I’d end up looking like a lobster or some other scarlet-coloured thingy, and also means that you are just looking at all the pretty fishies and rays (and a shark or 2) from above. So I decided to take the plunge (he he!) and do a diving course while I’m here. I’ve spent the last few days watching the (very dull and corny) videos, and have now finished all the theory parts of the course. Now to actually get in the water.........unfortunately the diving instructors are going on holiday on Monday for 2 weeks so I can’t finish it until they get back. So I’m back to snorkelling in the mean-time but I can handle that.

The water here is absolutely crystal clear, and the visibility is meant to be amongst the best in the world. Even just snorkelling I managed to see a huge array of fish and even the one reef shark (thankfully small and moving AWAY from me). When the group of people diving were 25m below, I was still able to tell who was who and give them a wave. The colour of the water at the shore is a stunning turquoise that I just can’t seem to capture in pictures. Unfortunately, most of the shores on the mainland are rocky and you don’t get the white sandy beaches but a few of the islands have those so the dive boat tends to stop off there for lunch.

This morning, Mia (Aussie Med student) and I decided we wanted to get out and do something on the water, so we hired a little dugout canoe – a steal at £5 for both of us for the morning. We didn’t go far, but it was lovely to see the town and nearby villages from the water.

I have a feeling I’ll be feeling it in my arms tomorrow morning though!